Maternal hydration and L-arginine supplementation improves liquor volume in patients with decreased liquor and prolongs pregnancy
Background: Oligohydramnios (reduced amniotic fluid) may be responsible for the problems of malpresentations, umbilical cord compression, meconium staining of amniotic fluid in the liquor, and difficult or failed external cephalic version. Simple intervention maternal hydration has been reported as...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2014-01-01
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| Series: | Medical Journal of Dr. D.Y. Patil University |
| Subjects: | |
| Online Access: | http://www.mjdrdypu.org/article.asp?issn=0975-2870;year=2014;volume=7;issue=4;spage=429;epage=434;aulast=Hebbar |
| _version_ | 1811262553733464064 |
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| author | Shripad Hebbar Lavanya Rai Prashant Adiga |
| author_facet | Shripad Hebbar Lavanya Rai Prashant Adiga |
| author_sort | Shripad Hebbar |
| collection | DOAJ |
| description | Background: Oligohydramnios (reduced amniotic fluid) may be responsible for the problems of malpresentations, umbilical cord compression, meconium staining of amniotic fluid in the liquor, and difficult or failed external cephalic version. Simple intervention maternal hydration has been reported as a way of increasing amniotic fluid volume in order to reduce some of these problems. Objective: To assess the influence of maternal hydration and l-arginine supplementation in improving liquor volume in patients with decreased liquor. Study Design: Prospective nonrandomized interventional study. Materials and Methods: 50 patients remote from term, with decreased liquor [amniotic fluid index (AFI) < 8] were enrolled in the study. Before the proposed intervention, the antenatal risk factors were studied. Patients with hypertensive disorders of pregnancy were administered l-arginine (one sachet 3 g, two times daily) and others received both arginine and intravenous hydration (500 ml of fructodex which contains 5% dextrose and 5% fructose, and lactated Ringer′s solution daily). The treatment was continued till the liquor improved significantly. However, patients were considered for delivery if the liquor remained less than 5. Mean increase in liquor, intervention delivery interval, and neonatal outcome were studied. Results: The mean gestational age at the time of recruitment was 33.4 1.9 weeks. The mean AFI at the time of enrolment was 6.9 (SD 0.8). These patients were delivered at 36.3 1.3 weeks, and thus, pregnancy could be prolonged by 2.9 weeks. The mean AFI at the end of therapeutic intervention was 9.3 (SD 1.7), and thus, an AFI increase of 2.4 could be obtained. There was no significant neonatal morbidity in these patients. Significant improvement in liquor volume was obtained in these patients after intervention with either or both l-arginine and fructodex infusion (P < 0.0001). The pregnancy could be prolonged from 33.4 weeks to 36.3 weeks. Conclusion: Treatment with l-arginine and fructodex resulted in significant improvement in liquor and prolongation of duration of pregnancy by around 3 weeks, which enabled us to administer steroids for lung maturation (in indicated cases). Thus, treatment with l-arginine and fructodex seems to be promising in improving fetal outcome in pregnancies complicated by decreased liquor. |
| first_indexed | 2024-04-12T19:27:47Z |
| format | Article |
| id | doaj.art-a90dffc6c134497d9b8d58c272e9506f |
| institution | Directory Open Access Journal |
| issn | 0975-2870 |
| language | English |
| last_indexed | 2024-04-12T19:27:47Z |
| publishDate | 2014-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Medical Journal of Dr. D.Y. Patil University |
| spelling | doaj.art-a90dffc6c134497d9b8d58c272e9506f2022-12-22T03:19:26ZengWolters Kluwer Medknow PublicationsMedical Journal of Dr. D.Y. Patil University0975-28702014-01-017442943410.4103/0975-2870.135255Maternal hydration and L-arginine supplementation improves liquor volume in patients with decreased liquor and prolongs pregnancyShripad HebbarLavanya RaiPrashant AdigaBackground: Oligohydramnios (reduced amniotic fluid) may be responsible for the problems of malpresentations, umbilical cord compression, meconium staining of amniotic fluid in the liquor, and difficult or failed external cephalic version. Simple intervention maternal hydration has been reported as a way of increasing amniotic fluid volume in order to reduce some of these problems. Objective: To assess the influence of maternal hydration and l-arginine supplementation in improving liquor volume in patients with decreased liquor. Study Design: Prospective nonrandomized interventional study. Materials and Methods: 50 patients remote from term, with decreased liquor [amniotic fluid index (AFI) < 8] were enrolled in the study. Before the proposed intervention, the antenatal risk factors were studied. Patients with hypertensive disorders of pregnancy were administered l-arginine (one sachet 3 g, two times daily) and others received both arginine and intravenous hydration (500 ml of fructodex which contains 5% dextrose and 5% fructose, and lactated Ringer′s solution daily). The treatment was continued till the liquor improved significantly. However, patients were considered for delivery if the liquor remained less than 5. Mean increase in liquor, intervention delivery interval, and neonatal outcome were studied. Results: The mean gestational age at the time of recruitment was 33.4 1.9 weeks. The mean AFI at the time of enrolment was 6.9 (SD 0.8). These patients were delivered at 36.3 1.3 weeks, and thus, pregnancy could be prolonged by 2.9 weeks. The mean AFI at the end of therapeutic intervention was 9.3 (SD 1.7), and thus, an AFI increase of 2.4 could be obtained. There was no significant neonatal morbidity in these patients. Significant improvement in liquor volume was obtained in these patients after intervention with either or both l-arginine and fructodex infusion (P < 0.0001). The pregnancy could be prolonged from 33.4 weeks to 36.3 weeks. Conclusion: Treatment with l-arginine and fructodex resulted in significant improvement in liquor and prolongation of duration of pregnancy by around 3 weeks, which enabled us to administer steroids for lung maturation (in indicated cases). Thus, treatment with l-arginine and fructodex seems to be promising in improving fetal outcome in pregnancies complicated by decreased liquor.http://www.mjdrdypu.org/article.asp?issn=0975-2870;year=2014;volume=7;issue=4;spage=429;epage=434;aulast=HebbarAmniotic fluid indexL-argininematernal hydration |
| spellingShingle | Shripad Hebbar Lavanya Rai Prashant Adiga Maternal hydration and L-arginine supplementation improves liquor volume in patients with decreased liquor and prolongs pregnancy Medical Journal of Dr. D.Y. Patil University Amniotic fluid index L-arginine maternal hydration |
| title | Maternal hydration and L-arginine supplementation improves liquor volume in patients with decreased liquor and prolongs pregnancy |
| title_full | Maternal hydration and L-arginine supplementation improves liquor volume in patients with decreased liquor and prolongs pregnancy |
| title_fullStr | Maternal hydration and L-arginine supplementation improves liquor volume in patients with decreased liquor and prolongs pregnancy |
| title_full_unstemmed | Maternal hydration and L-arginine supplementation improves liquor volume in patients with decreased liquor and prolongs pregnancy |
| title_short | Maternal hydration and L-arginine supplementation improves liquor volume in patients with decreased liquor and prolongs pregnancy |
| title_sort | maternal hydration and l arginine supplementation improves liquor volume in patients with decreased liquor and prolongs pregnancy |
| topic | Amniotic fluid index L-arginine maternal hydration |
| url | http://www.mjdrdypu.org/article.asp?issn=0975-2870;year=2014;volume=7;issue=4;spage=429;epage=434;aulast=Hebbar |
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